Endoscopic surgery interventions represent a significant advance in various fields of surgery permitting the performance of the majority of interventions through a number of small incisions reducing postoperative pain and enhancing postoperative recovery.
In endoscopic surgery, the surgeon performs the operation through small holes using long instruments and observing the internal anatomy with an endoscope camera.
However there are still a significant number of drawbacks to this technique. The fixed position of the access openings in the wall of the cavity access-ports significantly limits the approach to some surgical locations making some interventions very long and technically demanding. Creation of additional ports may negate the minimal invasive nature of the procedure. Some ports are used mainly for introducing retracting instruments in order to better access to the exact surgery location.
The fixed position of the ports may hinder retraction in various directions, and the limited potential access sites (as for example anterior and lateral walls, but not posterior, proximal and distal walls of the abdomen for abdominal laparoscopy) may make retraction in some directions impossible.
This invention relates to anchoring devices for retractors, being attached to the internal surface of a cavity or to various organs within a cavity, during minimally invasive surgery.
Magnetic attraction has been used in medicine to remotely attach devices to tissue, or to remotely manipulate tissue. So, in U.S. Pat. No. 6,358,196, issued to RAYMAN REIZA magnetic substances are introduced into the intestine by ingestion and the intestines are remotely manipulated by an electromagnet during laparoscopic surgery. However this device does not permit retraction of an abdominal organ other than intestine and does not permit precise retraction of a particular segment of intestine. Also it should be pointed out that the magnets might have impact on other metal instruments during operations and has limited options for obese patients where tissues thickness requires extremely strong magnets. The present invention, on the contrary, provides a clip for general use in surgeries in addition to internal retraction.
In U.S. patent application 2003/009080 and in U.S. Pat. No. 6,494,211, a suction device is used to attach a retractor to various organs such as the heart in order to retract it in a specific direction. However these devices are introduced trough orifices in the body wall and they are not virtual ports since they can not permit non invasive anchoring of the retractor to the undersurface of the cavity wall, or within the cavity in another location than the access port. In other words, the device as provided by the above mentioned patent and patent application ‘holds’ the suction outside the body rather than self anchoring the device within the body.
In PCT No. W003013366 and in U.S. Pat. No. 6,206,827 a retractor device is attached to the organ to be retracted by some adhesive. However, the retractors are introduced through an orifice and do not represent a virtual port since they can not permit non invasive anchoring of the retractor to the undersurface of the cavity wall, or within the cavity in another location than the access port. Again, as described above, the above mentioned patent requires outside grabbing of the device.
In U.S. Pat. No. 6,206,827, a retractor is directly attached to tissue by penetrating it with mechanical sharp means such as barbs or springs and traction on this means cause tissue retraction. However, the retractors are introduced through an orifice and do not represent a virtual port since they can not permit non invasive anchoring of the retractor to the undersurface of the cavity wall, or within the cavity in another location than the access port. Again, as described above, the above mentioned patent requires outside grabbing of the device.
Thus, there is a long felt need for a better anchoring device that permits anchoring of the retractor to the undersurface of the cavity wall without adding additional significant incisions to the abdominal wall
For a self anchoring device there is a need for a device diameter which will fit standard trocars, such as 5 mm diameter, and obtaining such clip with which the desired force could be exerted is very challenging.
The present invention presents a mechanical implementation of such clip, system and method for use this clip for retraction of internal organs during minimally invasive surgery.